| dc.identifier.citation | Pisani, P. and Airoldi, M. and Allais, A. and Valletti, P.A. and Battista, M. and Benazzo, M. and Briatore, R. and Cacciola, S. and Cocuzza, S. and Colombo, A. and Conti, B. and Costanzo, A. and della Vecchia, L. and Denaro, N. and Fantozzi, C. and Galizia, D. and Garzaro, M. and Genta, I. and Iasi, G.A. and Krengli, M. and Landolfo, V. and Lanza, G.V. and Magnano, M. and Mancuso, M. and Maroldi, R. and Masini, L. and Merlano, M.C. and Piemonte, M. and Pisani, S. and Prina-Mello, A. and Prioglio, L. and Rugiu, M.G. and Scasso, F. and Serra, A. and Valente, G. and Zannetti, M. and Zigliani, A., Metastatic disease in head & neck oncology, Acta Otorhinolaryngologica Italica, 2020 Apr;40(SUPPL. 1):S1-S86 | en |
| dc.description.abstract | The head and neck district represents one of the most frequent sites of cancer, and the percentage of metastases is very high in both loco-regional and distant areas. Prognosis refers to several factors: a) stage of disease; b) loco-regional relapses; c) distant metastasis. At diagnosis, distant metastases of head and neck cancers are present in about 10% of cases with an additional 20-30% developing metastases during the course of their disease. Diagnosis of distant metastases is associated with unfavorable prognosis, with a median survival of about 10 months. The aim of the present review is to provide an update on distant metastasis in head and neck oncology. Recent achievements in molecular profiling, interaction between neoplastic tissue and the tumor microenvironment, oligometastatic disease concepts, and the role of immunotherapy have all deeply changed the therapeutic approach and disease control. Firstly, we approach topics such as natural history, epidemiology of distant metastases and relevant pathological and radiological aspects. Focus is then placed on the most relevant clinical aspects; particular attention is reserved to tumours with distant metastasis and positive for EBV and HPV, and the oligometastatic concept. A substantial part of the review is dedicated to different therapeutic approaches. We highlight the role of immunotherapy and the potential effects of innovative technologies. Lastly, we present ethical and clinical perspectives related to frailty in oncological patients and emerging difficulties in sustainable socio-economical governance. | en |
